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痴呆症患者长期护理中工作人员与住院医生的互动:满足心理需求对实现患者福祉的作用。

Staff-resident interactions in long-term care for people with dementia: the role of meeting psychological needs in achieving residents' well-being.

作者信息

Willemse Bernadette M, Downs Murna, Arnold Lonneke, Smit Dieneke, de Lange Jacomine, Pot Anne Margriet

机构信息

a Program on Aging, Netherlands Institute of Mental Health and Addiction , Utrecht , The Netherlands.

出版信息

Aging Ment Health. 2015;19(5):444-52. doi: 10.1080/13607863.2014.944088. Epub 2014 Aug 13.

Abstract

OBJECTIVES

The aim of this study is to explore the extent to which staff-resident interactions address or undermine residents' psychological needs and how such interactions are associated with residents' well-being.

METHOD

Data on staff-resident interactions and residents' well-being were collected for 51 residents from nine long-term care settings using dementia care mapping (DCM). DCM yields a count and detailed description of staff-resident interactions that either address (personal enhancers - PEs) or undermine (personal detractions - PDs) residents' psychological needs, and every 5-minute scores for each resident's mood and engagement (ME-value). The relationship between PEs and PDs and well-being was analysed by studying residents' ME-values before and three time frames after a PE or PD occurred.

RESULTS

A total of 76 PEs and 33 PDs were observed. The most common PEs were those addressing psychological needs for comfort and occupation. However residents' well-being increased most often after PEs that addressed residents' need for identity, attachment and inclusion. The most common PDs were those which undermined the need for comfort, inclusion and occupation. Residents' well-being decreased most often after PDs that undermined the need for comfort.

CONCLUSION

Increasing interactions which address residents' need for attachment, identity and inclusion and eliminating interactions which undermine residents' need for comfort may be particularly important in achieving residents' well-being. In the long run, residents' well-being could be achieved by staff availing of the opportunities to empower and facilitate residents, thus meeting their needs for occupation. These findings provide directions for training in person-centred care.

摘要

目的

本研究旨在探讨工作人员与居民之间的互动在多大程度上满足或损害了居民的心理需求,以及这种互动与居民幸福感之间的关联。

方法

使用痴呆症护理图谱(DCM)收集了来自九个长期护理机构的51名居民的工作人员与居民互动及居民幸福感的数据。DCM会对满足(个人促进因素 - PEs)或损害(个人减损因素 - PDs)居民心理需求的工作人员与居民互动进行计数和详细描述,并给出每位居民情绪和参与度的每5分钟评分(ME值)。通过研究PE或PD发生前及发生后的三个时间框架内居民的ME值,分析PE和PD与幸福感之间的关系。

结果

共观察到76次PE和33次PD。最常见的PE是满足舒适和活动心理需求的互动。然而,满足居民身份认同、依恋和包容需求的PE之后,居民的幸福感提升最为常见。最常见的PD是损害舒适、包容和活动需求的互动。损害舒适需求的PD之后,居民的幸福感下降最为常见。

结论

增加满足居民依恋、身份认同和包容需求的互动,消除损害居民舒适需求的互动,对于实现居民的幸福感可能尤为重要。从长远来看,工作人员利用机会赋予居民权力并为其提供便利,从而满足他们的活动需求,可能实现居民的幸福感。这些发现为以人为主的护理培训提供了方向。

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